The whole concept of insurance is that you will take individual risks and spread them among many people so that if they actually occur, one will not be overwhelmed. One can either pay a $100,000 surgery bill once or pay a few hundred dollars a month in level premium; essentially spreading risks over a longer period of time.
Insurance is all about spreading risks. Risk doesn't mean that something will happen but that there is a chance of happening. We all individually have a risk or chance of a major illness. Our behavior, life style, and genetics may affect that risk but it is never zero and rarely 100%.
Just to review, Insurance, including health is used to take individual risks and spread over a large number of people and a longer period of time. Instead of paying $100,000 one month (which would bankrupt many people), one may pay $800 monthly. We take out the peaks of medical costs and make it more manageable with a stable monthly premium. The health insurance carrier is essentially the entity that manages the incoming monthly premium and outgoing medical reimbursement for all the people in the risk pool.
Coverage of any particular issue is decided by the insurance carrier who writes the policy. An insurance policy is an adhesion contract offered on a "take it or leave it basis" (you don't get to negotiate over the terms), the insurance carrier makes coverage decisions.
Free market?
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